Post Micturition Dribble

What is Post Micturition Dribble?

Post micturition dribble (PMD), also known as ‘after-dribble’ refers to involuntary urine leakage in men and women, experienced after urination. Unlike terminal dribble, which occurs during voiding itself, PMD urinary incontinence typically happens after leaving the toilet. While this issue can also affect women, it is prevalent for around 12% of men and just 8.5% of women, and has been found to worsen with male age. Involuntarily leaking urine after urination largely occurs as a result of urine that remains in the urethra, and tends to persist despite gently shaking or waiting immediately after urination.

Post micturition dribble causes and risk factors

PMD typically correlates with either a reduced strength or increased tone of the pelvic floor muscles around the urethra. Symptoms will most often include obvious signs including male incontinence itself, as well as feelings of needing to strain while urinating, or the desire to urinate more frequently. Factors especially discovered to pose a high risk of PMD in many cases include –

  • Obesity
  • Neurological damage
  • Persistent heavy lifting
  • Surgical complications
  • Age

Post micturition dribble diagnosis

PMD and male incontinence, in general, are far more prevalent than many of us realise, and diagnosis is fast, efficient, and certainly nothing to be embarrassed by. Most commonly, PMD diagnosis will take the form of two primary strategies, which are –

  • Physical examination that includes external perennial assessment and/or internal rectal examination to determine the efficiency of pelvic floor muscles. 
  • Ultrasound assessment to ensure the bladder is emptying completely and that residual volume is not the problem.

Post micturition dribble treatment

Treatment typically centres around exercises designed to improve the function of the pelvic floor. While it is recommended to wear a continence pad/shield to avoid leakage on clothes etc. before benefits can be seen, these exercises should enable you to eliminate or reduce the severity of PMD. In-clinic options especially revolve around –

  • Pelvic floor muscle release/training
  • Biofeedback transperineal ultrasound to correct pelvic floor contraction
  • Bulbourethral massage to efficiently empty urine from the urethra.

Further to this, male incontinence home remedies should be implemented daily to improve your pelvic floor, including exercises to complete during and immediately after urination. Your physiotherapist may also advise some basic changes to current toilet habits, including –

  • Waiting a little longer before leaving after urination
  • Practising exercises immediately after every urination
  • Applying gentle pressure to encourage urine forward after urination.

PMD? Not a problem for Sydney Pelvic Clinic

As Sydney’s Centre of Excellence for Pelvic Health, we have extensive experience in the diagnosis and treatment of PMD, allowing us to provide personalised treatment plans to address the underlying causes, and physical symptoms, of this problem. Our dedicated physiotherapists will especially work with you to understand what’s going wrong, what you can do to change it, and what life without PMD looks like at long last. Enjoy these benefits and more by booking an appointment today, and starting on a new and improved you.